小檗碱联合复方左炔诺孕酮对多囊卵巢综合征及肠道菌群的影响  

Effect of berberine combined with compound levonorgestrel on polycystic ovary syndrome and intestinal flora

作　　者：陈琛 苏圣梅 曾薇薇[1] 刘剀[1] 都红蕾[1] CHEN Chen;SU Shengmei;ZENG Weiwei;LIU Kai;DU Honglei(Department of Gynecology,Shenzhen Maternal and Child Healthcare Hospital Affiliated to Southern Medical University,Shenzhen,Guangdong 518028,China)

机构地区：[1]南方医科大学附属深圳市妇幼保健院妇科,广东深圳518028

出　　处：《现代医药卫生》2022年第23期4022-4028,共7页Journal of Modern Medicine & Health

摘　　要：目的探讨小檗碱联合复方左炔诺孕酮对多囊卵巢综合征(PCOS)及肠道菌群的影响。方法选取2018年7月至2021年6月该院妇科收治的90例PCOS患者,采用随机数字表法分为对照组和观察组,每组45例。对照组给予复方左炔诺孕酮片,观察组在对照组基础上联合小檗碱片,比较2组临床疗效及血清激素指标、炎症因子指标及糖脂代谢指标变化情况,同时对2组肠道菌群分布情况及不良反应发生率进行分析。结果观察组治疗后总有效率显著高于对照组,差异有统计学意义(P=0.036)。2组治疗后血清睾酮、促黄体生成素(LH)、LH/促卵泡素、硫酸脱氢表雄酮、游离雄性激素指数及性激素结合球蛋白水平优于治疗前,且观察组各指标优于对照组,差异有统计学意义(P<0.05)。2组治疗后空腹血糖、空腹胰岛素、糖化血红蛋白(HbA1c)、胰岛素抵抗指数、甘油三酯、高密度脂蛋白胆固醇、肿瘤坏死因子-α、超敏C反应蛋白及白细胞介素-6水平及低于治疗前,且观察组各指标(HbA1c除外)低于对照组,差异有统计学意义(P<0.05)。观察组治疗后乳酸杆菌和双歧杆菌菌落数高于对照组,而肠杆菌菌落数低于对照组,差异有统计学意义(P<0.05)。观察组肠道菌群丰度、Shannon-Wiener指数高于对照组,差异有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P=0.777)。结论小檗碱与复方左炔诺孕酮联合用药可有效提高治疗PCOS的疗效,显著改善患者生殖激素水平失调、糖脂代谢异常、慢性低度炎症状态,其机制可能与小檗碱改善肠道菌群紊乱有关。Objective To investigate the effect of berberine combined with compound levonorgestrel on polycystic ovary syndrome(PCOS)and intestinal flora.Methods From July 2018 to June 2021,90 PCOS pa-tients admitted to the gynecology department of the hospital were selected and randomly divided into control group and observation group with 45 patients in each group.The control group was given compound levonorg-estrel tablets,and the observation group was combined with berberine tablets on the basis of the control group.The clinical efficacy,serum hormone indicators,inflammatory factor indicators and glycolipid metabo-lism indicators of the two groups were compared,and the intestinal microbiota distribution and adverse reac-tion rate of the two groups were analyzed.Results The total effective rate of the observation group after treatment was significantly higher than that of the control group,with a statistically significant difference(P=0.036).After treatment,the levels of serum testosterone,luteinizing hormone(LH),LH/follicle stimulating hormone,dehydroepiandrosterone sulfate,free androgen index and sex hormone binding globulin in the two groups were better than those before treatment,and the indicators in the observation group were better than those in the control group,with statistical significance differences(P<0.05).After treatment,the levels of fasting blood glucose,fasting insulin,glycosylated hemoglobin(HbA1c),insulin resistance index,triglyceride,high-density lipoprotein cholesterol,tumor necrosis factor-α,high-sensitivity C-reactive protein and interleu-kin-6 in the two groups were lower than those before treatment,and the indexes in the observation group(ex-cept HbA1c)were lower than those in the control group,with statistical significance differences(P<0.05).After treatment,the numbers of lactobacillus and bifidobacterium colonies in the observation group were high-er than that in the control group,while the number of enterobacteria colonies in the observation group was lower than that in the control group,with

关 键 词：小檗碱 复方左炔诺孕酮 多囊卵巢综合征 肠道菌群 

分 类 号：R711[医药卫生—妇产科学]